Tetralogy of Fallot
Conditions
Keywords
FALLOT disease, CARTO, 3Dimension Echocardiography, mecanichal and electrical activation
Brief summary
The objective of this work is to estimate the correlation between the electrical activation of the VD measured by the CARTO electrophysiological mapping system and the mechanical activation of the VD measured by 3D echocardiography and 3D speckle-tracking. Our hypothesis is that there is a strong correlation between electrical activation and mechanical activation in patients with an operated Fallot tetralogy.
Detailed description
Fallot tetralogy is the most common cyanogenic congenital heart disease. Thanks to advances in surgery, most patients survive to adulthood but develop a failure of the function of the right ventricle and then of the left ventricle resulting in progressive heart failure and death of patients. Despite corrective surgeries in adulthood, including pulmonary valve surgery, heart failure remains a major problem. One of the mechanisms of this heart failure is the right intraventtricular asynchronism associated with the postoperative right branch block, which will secondaryly become complicated from an interventricular asynchronism for left intraventtricular, partly explaining the overall progressive failure of cardiac function. To date, there is no model for combining a combined analysis of electrical and mechanical activation in the same patients. Understanding these mechanisms would allow us to better understand the pathophysiology of heart failure in this population and to propose targeted therapies to prevent this asynchronism by adapting surgical techniques, or treating this asynchronism with electrical therapy such as bivascular resynchronization. Each patient in each group will perform, according to standard practice, an electrophysiological exploration with mapping of the heart using the CARTO system, a cardiac MRI and a 3-dimensional transthoracic echocardiography. The follow-up of each patient takes place during a scheduled hospitalization as part of the care. Their participation in the study only lasts for the duration of the hospitalization.
Interventions
OTHERElectrophysiological exploration of the right ventricle
* CARTO electrophysiological mapping system * 3D echocardiography * High Resolution MRI
Sponsors
University Hospital, Bordeaux
Reference Centre for Rare Diseases Malformations Congenital Heart Complexes (CRMR M3C-Bordeaux)
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion Criteria in the Fallot group * Male or female patient aged 18, * Patient with Fallot Tetralogy operated. nclusion Criteria in the Control group * Male or female patient aged 18, * Patient benefiting from electrophysiological exploration for a healthy heart arrhythmia, * Patient with a significant lack of heart disease.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Comparison of electrical and mechanical activation by computational morphometry with temporal recalling to define electromechanical activation maps in healthy subjects and patients with Fallot tetralogy operated. | Day 0 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Area strain VD 3D global in % | Day 0 | Global 3D VD longitudinal strain in %, Global 3D VD circumferential strain in %, Mean deformation pattern, Mean RV right ventricle shape, RV Average Curvature Index. |
| Strain longitudinal VD 3D at the 8 segments in % | Day 0 | — |
| Strain circumferential VD 3D at the 8 segments in % | Day 0 | — |
| Comparison of 3D VD volume data between different populations | Day 0 | 3D VD Ejection Fraction and End-Diastolic and End-Systolic Volume 3D VD; 3D right ventricle volume data processed by Tomtec 4D RV Function 2.0. |
| Inter-evaluator variability of 3D deformation parameters | Day 0 | Area strain 3D in %, Longitudinal strain in %, Circumferential strain in %, Global 3D at right ventricle level. |
| Intra-evaluator variability of 3D deformation parameters | Day 0 | Area strain 3D in %, Longitudinal strain in %, Circumferential strain in %, Global 3D at right ventricle level. |
| MR Analysis | Day 0 | * Right and Left Ventricular MRI Volumetry; * Pulmonary flow by MRI. * T1 spontaneous (ms) and extracellular volume fraction (%) by MRI * MRI scar area |
| Comparison of electrical activation maps based on anatomical data | Day 0 | Comparison of electrical activation maps based on anatomical data, including diffuse fibrosis and scars in Fallot subjects |
Countries
France
Contacts
STUDY_DIRECTORXavier IRART, MD
University Hospital, Bordeaux
Outcome results
None listed